Implications for practice and research

■ Data support the use of regular exercise to improve cardiovascular health in patients undergoing renal replacement therapy
albeit robust data from large scale randomised controlled trials (RCTs) designed to investigate cardiovascular health outcomes
are lacking.

■ Clinicians should counsel patients with chronic kidney disease (CKD) to increase physical activity levels and inform them
that there is scientific evidence that regular exercise benefits health. Potential referral to clinical exercise programs
should be considered.

■ Future studies should stratify participants based on CKD aetiology and stage, include sufficient sample size, and employ a
rigorous RCT design using exercise as an adjunctive …